Haematological changes in pregnancy
[Ref: PK1:p350]
Haematology
Plasma volume increases (45%) relatively more than RBC volume increase (20%)
Thus,
- [Hb] falls to 12-13g/L
- Haematocrit falls to 33-35%
Also,
- WBC count increases to 8 to 9 x 10^6/L
* Due to increase in neutrophil and monocytes
NB:
According to [KB2:p6],
- Without iron supplementation
--> RBC volume increase by 250mLs (18%)
- With iron supplementation
--> RBC volume increase by 450mLs (30%)
Coagulation
Significant increase in plasma concentration of
- Factor 7,8,9,10
- Fibrinogen
Platelet concentration is unchanged or slightly decreased due to haemodilution
NB:
According to [AA4:p328],
- Factor II, V slightly increased
- Factor VII increase 10-fold
- Factor VIII increase 2-fold
- Factor IX and X increased
- Factor XII increase 30-40%
- Factor XI and XIII decreased
- Plasminogen inhibitor increased
- Plasminogen activator reduced
- Antithrombin IIIa decreased slightly
Plasma proteins
- Total circulating protein increase during pregnancy
But,
- Concentration of total protein and albumin decrease due to haemodilution
Other proteins
- Increase in total globulin
* Increase in alpha and beta-globulin
* Slight decrease in gamma-globulin
- Fibrinogen increases
* From 300mg/dL to 450mg/dL at term
- Serum pseudocholinesterase activity
* Reduced by 20-30% by the end of 1st trimester
* Constant until term